Skip to main content

Advertisement

Log in

Observation of cerebral aneurysm wall thickness using intraoperative microscopy: clinical and morphological analysis of translucent aneurysm

  • Original Article
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

Intracranial aneurysms suffer various interactions between hemodynamics and pathobiology, and rupture when this balance disrupted. Aneurysm wall morphology is a result of these interactions and reflects the quality of the maturation. However, it is a poorly documented in previous studies. The purpose of this study is to observe aneurysm wall thickness and describe the characteristics of translucent aneurysm by analyzing clinical and morphological parameters. 253 consecutive patients who underwent clipping surgery in a single institute were retrospectively analyzed. Only middle cerebral artery aneurysms (MCA) which exposed most part of the dome during surgery were included. Aneurysms were categorized based on intraoperative video findings. Aneurysms more than 90 % of super-thin dome and any aneurysms with entirely super-thin-walled daughter sac were defined as translucent aneurysm. A total of 110 consecutive patients with 116 unruptured MCA aneurysms were included. Ninety-two aneurysms (79.3 %) were assigned to the not-translucent group and 24 (20.7 %) to the translucent group. The relative proportion of translucent aneurysm in each age group was highest at ages 50–59 years and absent at ages 30–39 and 70–79 years. There was a trend that translucent aneurysms were smaller in size (p = 0.019). Multivariate logistic analysis showed that translucent aneurysm was strongly correlated with height <3 mm (p = 0.003). We demonstrated that the translucent aneurysms were smaller in size and the aneurysm height <3 mm was related. These results may provide information in determining treatment strategies in patients with small size aneurysm.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Meng H, Tutino VM, Xiang J, Siddiqui A (2013) High wss or low wss? Complex interactions of hemodynamics with intracranial aneurysm initiation, growth, and rupture: toward a unifying hypothesis. Am J Neuroradiol

  2. Kadasi LM, Dent WC, Malek AM (2013) Colocalization of thin-walled dome regions with low hemodynamic wall shear stress in unruptured cerebral aneurysms. J Neurosurg 119(1):172–179

    Article  PubMed  Google Scholar 

  3. Elsharkawy A, Lehecka M, Niemela M et al (2013) Anatomic risk factors for middle cerebral artery aneurysm rupture: computed tomography angiography study of 1009 consecutive patients. Neurosurgery 73(5):825–837 discussion 836–827

    Article  PubMed  Google Scholar 

  4. Raghavan ML, Ma B, Harbaugh RE (2005) Quantified aneurysm shape and rupture risk. J Neurosurg 102(2):355–362

    Article  PubMed  Google Scholar 

  5. Costalat V, Sanchez M, Ambard D et al (2011) Biomechanical wall properties of human intracranial aneurysms resected following surgical clipping (irras project). J Biomech 44(15):2685–2691

    Article  CAS  PubMed  Google Scholar 

  6. Ingall T, Asplund K, Mahonen M, Bonita R (2000) A multinational comparison of subarachnoid hemorrhage epidemiology in the who monica stroke study. Stroke 31(5):1054–1061

    Article  CAS  PubMed  Google Scholar 

  7. Naggara ON, White PM, Guilbert F, Roy D, Weill A, Raymond J (2010) Endovascular treatment of intracranial unruptured aneurysms: systematic review and meta-analysis of the literature on safety and efficacy. Radiology 256(3):887–897

    Article  PubMed  Google Scholar 

  8. Wiebers DO, Whisnant JP, Huston J 3rd et al (2003) Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet 362(9378):103–110

    Article  PubMed  Google Scholar 

  9. Sonobe M, Yamazaki T, Yonekura M, Kikuchi H (2010) Small unruptured intracranial aneurysm verification study: suave study, Japan. Stroke 41(9):1969–1977

    Article  PubMed  Google Scholar 

  10. Forget TR Jr, Benitez R, Veznedaroglu E et al (2001) A review of size and location of ruptured intracranial aneurysms. Neurosurgery 49(6):1322–1325 discussion 1325–1326

    Article  PubMed  Google Scholar 

  11. Dhar S, Tremmel M, Mocco J et al (2008) Morphology parameters for intracranial aneurysm rupture risk assessment. Neurosurgery 63(2):185–196 discussion 196–187

    Article  PubMed Central  PubMed  Google Scholar 

  12. Asari S, Ohmoto T (1994) Growth and rupture of unruptured cerebral aneurysms based on the intraoperative appearance. Acta Med Okayama 48(5):257–262

    CAS  PubMed  Google Scholar 

  13. Steiger HJ, Aaslid R, Keller S, Reulen HJ (1989) Strength, elasticity and viscoelastic properties of cerebral aneurysms. Heart Vessels 5(1):41–46

    Article  CAS  PubMed  Google Scholar 

  14. Kataoka K, Taneda M, Asai T, Kinoshita A, Ito M, Kuroda R (1999) Structural fragility and inflammatory response of ruptured cerebral aneurysms. A comparative study between ruptured and unruptured cerebral aneurysms. Stroke 30(7):1396–1401

    Article  CAS  PubMed  Google Scholar 

  15. Frosen J, Piippo A, Paetau A et al (2004) Remodeling of saccular cerebral artery aneurysm wall is associated with rupture: histological analysis of 24 unruptured and 42 ruptured cases. Stroke 35(10):2287–2293

    Article  PubMed  Google Scholar 

  16. Sherif C, Kleinpeter G, Mach G et al (2014) Evaluation of cerebral aneurysm wall thickness in experimental aneurysms: comparison of 3t-mr imaging with direct microscopic measurements. Acta Neurochir (Wien) 156(1):27–34

    Article  Google Scholar 

  17. Ujiie H, Tamano Y, Sasaki K, Hori T (2001) Is the aspect ratio a reliable index for predicting the rupture of a saccular aneurysm? Neurosurgery 48(3):495–502 discussion 502–493

    Article  CAS  PubMed  Google Scholar 

  18. Weir B (2002) Unruptured aneurysms. J Neurosurg 97(5):1011–1012 discussion 1012–1013

    Article  PubMed  Google Scholar 

  19. Weir B (2002) Unruptured intracranial aneurysms: a review. J Neurosurg 96(1):3–42

    Article  PubMed  Google Scholar 

  20. Allcock JM, Canham PB (1976) Angiographic study of the growth of intracranial aneurysms. J Neurosurg 45(6):617–621

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yong Sam Shin.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Song, J., Park, J.E., Kim, H.R. et al. Observation of cerebral aneurysm wall thickness using intraoperative microscopy: clinical and morphological analysis of translucent aneurysm. Neurol Sci 36, 907–912 (2015). https://doi.org/10.1007/s10072-015-2101-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-015-2101-9

Keywords

Navigation